Pediatric Migraines: A Comprehensive Review and Perspectives on Diagnosis and Treatment

Episodic Migraine in the Pediatric Population: Behavioral Therapies and other Non-Pharmacological Treatment Options

PURPOSE OF REVIEW

The purpose of this review is to present current evidence on the multifaceted approach required for managing pediatric migraine. This includes identifying migraine triggers, managing acute pain episodes, and implementing preventive strategies. The review focuses on non-pharmacological interventions, such as behavioral and lifestyle modifications. By exploring these aspects, the review seeks to provide a comprehensive understanding of effective migraine management in children and adolescents.

RECENT FINDINGS

Non-pharmacological treatments like cognitive-behavioral therapy (CBT), relaxation techniques, and biofeedback are effective alternatives to medication. Nutraceuticals and dietary considerations, including ketogenic diet, alongside education and regular follow-ups, optimize outcomes. Integrating tools for tracking migraine patterns and training for clinicians, parents, and patients enhances treatment effectiveness. Engaging adolescents and their families through education and active participation is essential for improving their quality of life. This review presents available evidence of non-pharmacological strategies for managing episodic migraine in pediatrics. CBT and lifestyle modification are documented for their effect. Future research is required to create evidence-based, comprehensive treatment plans including these and other non-pharmacological strategies tailored to individual needs.

Current psychological intervention alternatives for the treatment of paediatric headaches: a narrative review

Headaches are considered as major health problems being common in childhood and adolescence and are debilitating, thus, they lead to poor quality and low performance in all walks of life. Among all types of headaches, episodic migraine and tension-type headache are commonly encountered in the aforementioned phases of life and are likely to have devastating impacts as they become chronic. Stress factors related to school, peers and family, mental problems and traumatic experience may play an essential role in the occurrence of headaches affecting the lives of children and adolescents deleteriously. In this regard, there is unanimity on the most effective treatment of both paediatric and adult headaches through a biopsychosocial approach in which specialists from different fields contribute to the process in a collective manner. There is strong evidence that psychological interventions, which are among the basic elements of holistic treatment, provide relief to patients, especially when applied in combination with pharmacological treatment options in the early period. In general, the research has indicated that such treatments significantly improve the quality of life of children and adolescents suffering from different types of headaches by reducing the frequency, duration and intensity of pain, as well as alleviating the psychological symptoms accompanying the pain. In line with the thorough literature overview, this study aims to shed light on the main goals, domains and scope of application of psychological interventions that are widely applied or considered auspicious in the multidisciplinary treatment of paediatric headache in general terms.

Benefit of Dietary Supplementation of Nutraceuticals as an Integrative Approach for Management of Migraine: Evidence From Preclinical and Clinical Studies

PURPOSE OF REVIEW

To provide information from preclinical and clinical studies on the biological activity and health benefits of dietary inclusion of nutraceuticals as a safe, effective, non-pharmacological approach for the treatment of migraine.

RECENT FINDINGS

There is emerging evidence of the therapeutic benefit of nutraceuticals to inhibit oxidative stress, suppress inflammation, and prevent changes in the normal gut microbiome, which are implicated in migraine pathology. Nutraceuticals can be enriched in polyphenols, which act as molecular scavengers to reduce the harmful effects of reactive oxygen species and phytosterols that suppress inflammation. Nutraceuticals also function to inhibit dysbiosis and to maintain the commensal intestinal bacteria that produce anti-inflammatory molecules including short-chain fatty acids that can act systemically to maintain a healthy nervous system. Dietary inclusion of nutraceuticals that exhibit antioxidant, anti-inflammatory, and anti-nociceptive properties and maintain the gut microbiota provides a complementary and integrative therapeutic strategy for migraine.